A 8 Fr sheath was inserted through right femoral artery, and the left coronary artery was engaged with an 8 Fr JL 4.0 catheter with side hole. The 0.014 inch BMW wire was inserted into the LAD. First, we checked the LAD lesion with IVUS and tight stenosis with encircling calcification was confirmed (Figure 2). Considering heavy calcification, we decided to perform rotablation. Then, a 0.014 inch Rotawire was placed into the LAD. Based on IVUS and angiography image, we performed with a rotablator 1.25mm burr and 1.5mm burr (Figure 3). After rotablation, we changed a 0.014 inch Rotawire into a 0.014 inch BMW wire at LAD. Pre-dilatation at pmLAD with a NC TREK balloon 2.5x2.0mm was performed (Figure 4). After pre-dilatation, we deployed the PROMUS Premier stent 3.0x28mm at mLAD (Figure 5), PROMUS Premier stent 3.5x24mm at pmLAD (Figure 6) and PROMUS Premier stent 4.0x24mm at LM-pLAD (Figure 7). Post-stenting adjunctive balloon dilatation with Quantum balloon 3.5x20mm, and 4.0x20mm was performed (Figure 8). Final angiogram showed that the procedure was successful ( Movie 2).
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